Puerto Rico is an island of 100 miles long by 35 miles wide. The population based on the 2000 census revealed a 3.8 million inhabitants with 1.9 million women and 1.8 million male. Our island cancer registry expects to show close to 11,300 new cancer cases for 2002 year. Although our cancer risk is less than that of US mainland, there is a real trend towards parity in the next few decades. Despite this, our population do show an excess incidence in cervical, endometrial and tobacco-related cancers. Equally important, our death rate is higher than mainland USA for selected sites such as lung, liver, stomach and esophageal cancer. The health care delivery system in the island has dramatically changed during the past decade. In 1994, there were 1,950,000 privately medically-insured citizens and 1,600,000 uninsured population. Most of the latter were cared by the government sector. A private health insurance (PR Health Care Reform) has since then been established and works through a capitation system that utilizes private insurance companies as intermediates between the government and the public sector. Currently for year 2002, 1,729,511 medically indigent are covered by the reform system. The San Juan Minority-Based Community Clinical Oncology Program (MBCCOP) was established in 1990 at the San Juan Hospital. The goals of the MBCCOP are to expand and strengthen quality cancer control and treatment research in a changing medical environment in our own communities; to provide access to state of the art cancer control and treatment; to involve a wide sector of health care professionals into the NIH/National Cancer Institute network; to provide educational and informational activities to professionals in their own communities. In 1990, the San Juan MBCCOP started within the PR Medical Center facilities. Since then, the Program has been extended to include satellite centers in Ponce, Bayamon and Manati. It has also included an active group of primary care physicians in their own offices. The Program currently works with several research bases in USA mainland such as National Surgical Adjuvant Breast and Bowel Project, Eastern Cooperative Oncology Group, MD Anderson Cancer Center, and the University of Michigan. Through our participation, a significant number of hispanic subjects have entered in NCI-sponsored trials. Our final goal is to offer the benefits of the NCI Program to the entire island population.